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Tales from the White House pharmacy are alarming, funds for abortions are dwindling, & mammography for dense breasts is challenging

January 23, 2024
Reporter, Morning Rounds Writer
Good morning. Every once in a while I feel like invoking a phrase I associate with humor columnist Dave Barry: "I am not making this up!" Britttany Trang's story today about a report listing the many ways a White House "pharmacy" (Barry was a fan of quotation marks, too) fell short brings that disclaimer to mind.

politics

White House pharmacy operated by its own rules

There is a "pharmacy" at the White House, and we're using scare quotes because the people who run it say it isn't one. And there's more, according to a new government watchdog's probe that discovered problems beneath pretty much every stone it overturned:

  • A doctor asked a staffer to "hook up" someone with a controlled substance "as a parting gift for leaving the White House."
  • Ambien and Provigil were dispensed without verifying the patient's identity.
  • Over-the-counter meds were in open bins for the grabbing.
  • Care was covered for ineligible personnel to the tune of a whopping $750,000.

"If this had been a traditional pharmacy, they certainly would have been cited by their state board of pharmacy," said Doug Hoey of the National Community Pharmacists Association, "and there's probably even an outside chance that they'd be shut down." Who's responsible for this? Good question. The White House did not comment on the report, the draft of which languished from May 2020 to July 2023. STAT's Brittany Trang has much more.


reproductive health

Demand for abortions is soaring, but donations to pay for them are falling

Right after the U.S. Supreme Court's Dobbs decision, donations skyrocketed to the 100 abortion funds working in collaboration across the country. The National Network of Abortion Funds collectively dispensed nearly $37 million to 102,855 people in the year that followed, up 88% from the year before. Networks help fund both medical and surgical abortions, which often aren't covered by insurance, and can also cover the costs of traveling to states where abortions are legal and accessible.

But while new state restrictions on abortion have made the costs higher for patients having to travel further to end pregnancies, donations are not keeping up with demand. "Every single abortion fund" has seen a drop in funding, said Bree Wallace, director of intake at the Tampa Bay Abortion Fund in Florida. "I think we're all at lower numbers than we'd like to be." STAT's Olivia Goldhill has more.


in the lab

New tool to trace blood cell ancestry hold promise to predict diseaseBlood_cell_tree_v6-1600x900

Courtesy Whitehead Institute

The human blood system is difficult to fathom. Just think: It relies on primitive stem calls deep in the bone marrow to create about 500 billion blood cells every day, STAT's Megan Molteni reminds us. There are immune cells that turn over in hours, platelets that live a week, red blood cells still around for a few months, and some white blood cells that last decades. When this complex system falls out of balance, disease can follow, from anemia (too few red blood cells) to leukemia (too many white blood cells). This all becomes apparent too late to know how, or how to stop it.

New research in Nature yesterday reveals a way to monitor what changes in blood cells, turning back the clock to potentially predict disease. "Our technology lets us reconstruct this history, like a detective story, and track down who was the bad actor that would eventually cause all these problems," study co-author Jonathan Weissman of the Whitehead Institute said about what for now remains a lab tool. Read more.



closer look

We know dense breast tissue raises cancer risk. What's next?mammo

Benoit Doppagne/Belga Mag/AFP via Getty Images

Having dense breasts can be problematic in two ways when getting a mammogram to detect cancer. There's a higher risk of cancer in fibrous tissue, and it's harder to see potential tumors because dense tissue looks like cancer in the image. That's why 38 U.S. states require health care providers to tell patients if they have dense breasts. But what happens next isn't so clear. Even though dense breasts are normal, there is no consensus on how best to screen for cancer if mammography falls short. 

Breast ultrasounds are one option, but high rates of false positives makes it less than ideal. MRIs are typically reserved for patients who have increased risk. Research is ongoing into such options as abbreviated MRIs, but as always, paying for these tests and finding a way to a center that offers them pose other barriers. STAT's Annalisa Merelli explores this issue.


neurology

Blood test for Alzheimer's shows promise

A blood test looking for signs of Alzheimer's disease performed as well as more burdensome lumbar punctures that sample cerebrospinal fluid, a JAMA Neurology paper published yesterday concludes. The test, commercially available but not widely used outside research studies, spots phosphorylated tau, which in turn signals the presence of abnormal amyloid and tau, two proteins that clump in the brains of people with dementia. The researchers, who compared blood samples from 786 people, following them for eight years and comparing their test to biomarkers from cerebrospinal fluid, found similar accuracy for the blood test.

"We will need further evidence to show that the blood test can accurately diagnose who is in the process of developing dementia, and that it can identify who is likely to benefit from treatments to slow down the disease," Charles Marshall of Queen Mary University of London, who was not involved in the study, said in a statement.


chronic disease

Study connects milk to lower risk of type 2 diabetes for people with lactase deficiency

People who can't digest dairy products after childhood may be surprised to hear that increasing cow's milk intake has been linked to a lower risk of developing type 2 diabetes for adults like them. A new study, posted yesterday in Nature Metabolism, connects that previously noted link to the microbiome: When people who no longer produce lactase (the enzyme that breaks down lactose) drank more milk, that changed certain bacteria in the gut microbiome and their metabolic by-products.

The researchers discovered this connection after following more than 12,000 participants in the Hispanic Community Health Study/Study of Latinos for about six years. Those who were lactase deficient had a 30% lower risk of type 2 diabetes with about one cup of milk added daily. Milk consumption made no difference for people who didn't lack lactase. Bolstering their case, the link between milk, the genotype for lactase deficiency, and type 2 diabetes risk matched what's found in 167,172 individuals in the U.K. Biobank.


Correction: In yesterday's newsletter we misidentified the outlet that published this story: I miscarried in Texas. My doctors put abortion law first, Newsweek


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What we're reading

  • Dana-Farber expands studies to be retracted or corrected over mishandled data, STAT
  • Maybe vitamins shouldn't taste like candy, The Atlantic

  • New York City plans to wipe out $2 billion in medical debt for 500,000 residents, Associated Press

  • Pharma's attack on Medicare drug price negotiation might benefit Biden, STAT
  • In Washington state, pharmacists are poised to start prescribing abortion drugs, NPR
  • Gilead's Trodelvy fails in lung cancer and raises new questions on antibody drug conjugate drugs, STAT

Thanks for reading! More tomorrow,


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